Sebastian Balestriere, ATC

Individual provider Active NPI Athletic Trainer · Pitman, NJ

NPI 1740600303 · NPPES record last updated Apr 22, 2014

Key facts

NPI
1740600303
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
25MT00041200 (NJ)
Practice address
614 Lambs Rd
Pitman, NJ 08071-2000
Phone
(856) 248-7191
NPI assigned
Apr 22, 2014
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
25MT00041200NJMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 25MT00041200 NJ Yes

Addresses

Primary practice location

614 Lambs Rd
Pitman, NJ 08071-2000

Mailing address

614 Lambs Rd
Pitman, NJ 08071-2000
Phone (856) 248-7191

Other providers in Pitman, NJ

All providers in Pitman, NJ · Athletic Trainer in New Jersey

Sources for this page

Verify at the official NPI Registry.